Using food questionnaires, researchers tracked the eating habits of almost 150,000 people every four years for an average of 20 years of follow-up. Their analysis took into account age, family history, race, smoking status, initial red meat consumption and lifestyle factors such as physical activity, alcohol intake and diet quality.

The study found that among those who ate more red meat as the study progressed showed higher rates of diabetes than those whose red meat consumption didn’t change.

Consuming 3.5 more servings of red meat per week during a four-year period increased a person’s chance of developing diabetes by almost 50 percent in the subsequent four years.

Those who consumed 3.5 less servings of read meat per week during a four-year period didn’t have a short-term reduced risk of developing the disease, but over the subsequent 10 years, reduced their risk of developing type 2 diabetes by 14 percent.

The findings apply to both processed red meats, such as lunch meat and hot dogs, and unprocessed red meat, such as hamburger, steak and pork. The association was stronger for processed meat.

Some experts suggest that the high calories and fat in red meat are to blame for the association between increased consumption and higher risk of diabetes. Indeed, people who are overweight are more likely to develop the condition. However, even after the researchers controlled for body mass index and weight gain, the linkage between increased red meat consumption and type 2 diabetes remained.

In an invited commentary in the journal , William J. Evans, Ph.D., head of the Muscle Metabolism Discovery Performance Unit at GlaxoSmithKline, and an adjunct professor of geriatric medicine at Duke University, suggests that the problem isn’t red meat, but the amount of saturated fat in the meat [2].

According to lead author An Pan, Ph.D. [3]:

The public-health message is to try to limit red-meat consumption (particularly processed red meat) and switch to plant-based food choices and more fish/poultry. While there is no cutoff point or recommendation regarding how many servings per week, the current evidence suggests the less, the better.

The study is the first to look at red meat consumption changes over time and how it affects diabetes risk.

References

1. Pan et al. Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes Mellitus. JAMA Intern Med. 2013;():1-8. doi:10.1001/jamainternmed.2013.6633.
2. Evans WJ. Oxygen-Carrying Proteins in Meat and Risk of Diabetes Mellitus. JAMA Intern Med. 2013;():1-2. doi:10.1001/jamainternmed.2013.7399.
3. Cutting Back on Red Meat May Lower Risk for Type 2 Diabetes. Medscape. 2013 Jun 18.

Last year for Men’s Health Week, we focused on the 7 threats to men’s health. This year, we’re spotlighting the infographic below from Georgetown University’s School of Nursing & Health Studies, which provides some current statistics as well as ways men can work to effect change and maintain and improve their health.

One of the things we particularly like is how the infographic highlights a number of preventative tests for men. Regular health tests are important because they can help find problems before they start. They also can help find problems early, when chances for treatment and cure are better. By getting the right health services, screenings and treatments, men are taking steps that increase their chances for living a longer, healthier life.

Blood pressure
High blood pressure can cause damage to body organs.

• Age 20+: every year

Blood tests & urinalysis
Blood and urine are used to screen for diseases such as cholesterol, diabetes, and kidney or thyroid dysfunction before symptoms occur.

• Age 20-39: every 3 years | Age 40-49: every 2 years | Age 50+: every year

Electrocardiogram (EKG)
An electrocardiogram or EKG is used to screen for heart abnormalities.

• Age 20-39: baseline | Age 40-49: every 4 years | Age 50+: every 3 years

Physical exam
Physical exams provide an overall health status report.

• Age 20-39: every 3 years | Age 40-49: every 2 years | Age 50+: every year

Rectal exam
A rectal exam is used to screen for hemorrhoids, lower rectal problems, colon cancer and prostate cancer.

• Age 20+: every year

Sexually transmitted diseases
Sexually active adults at risk for STDs should be screened regularly.

• Age 20+: talk to your doctor

TB skin test
A tuberculosis skin test should be done on occasion of exposure or suggestive symptoms.

• Age 20+: every 5 years

Chest x-ray
A chest x-ray detects lung cancer and should be considered among smokers over the age of 45.

• Age 40+: talk to your doctor

Hemoccult
A hemoccult is a quantitative test for hidden blood in stool, a screen for early signs of polyps or colon cancer.

• Age 40+: every year

Testosterone screening
A testosterone screen checks for low testosterone.

• Age 40+: talk to your doctor

Colorectal health
A colorectal examination checks the rectum, sigmoid and descending colon for early signs of cancer.

• Age 50+: every 3-4 years

PSA blood test
Tests levels of prostate specific antigen for infection, enlargement, or cancer.

• Age 50+: every year (earlier if you have a family history of prostate cancer)

Bone health
Bone mineral density test.

• Age 60+: talk to your doctor

For more information on which screening tests to get, see the checklist on the Agency for Healthcare Research & Quality (AHRQ): Men: Stay Healthy at Any Age — Checklist for Your Next Checkup

Via: Georgetown University School of Nursing & Health Studies

According to Orlando Portale, PMC’s chief innovation officer [1]:

We used a lot of evidence-based design principles to improve the patient experience and the staff experience. It is a radical departure in design.

For example, the 740,000-square-foot, 288-bed hospital has done away with traditional nurse stations. Instead, there are nurse stations outside of patient rooms, where they can do charting while keeping on eye on the patient. Staff are equipped with phones that run over the Internet, allowing them to get real-time patient information.

Additional innovations aimed at improving patient care include:

• Patient wrist-worn devices that measure vital signs and allow for continuous and remote wireless monitoring
• Infrared technology that illuminates faucets when someone enters a patient room, reminding them to wash their hands
• Hydraulic lifts built into the ceiling to help staff with heavier patients
• Standardized designs so the equipment is located in the same place in every room

Palomar Health Chief Nurse Executive Lorie Shoemaker said [2]:

Patients being awakened from much needed sleep to have their vital signs taken will become a thing of the past. Rather than checking vital signs every several hours, our participating clinicians will be able to obtain continuous measurements without disturbing the patient, and receive instant alerts if a patient’s condition begins to deteriorate. At the bedside, they can simply tap the ViSi Mobile monitor for an instant reading of heart rate and pulse, or they can check from a remote viewing device.

Palomar Medical Center (PMC) was featured recently in a new Bloomberg TV series called BRINK, which focuses on emerging innovators and their cutting-edge technologies that are transforming industries such as health care. Check out the video below.

Technologies that were taped for the show include: the ViSi Mobile System, a wrist-worn patient vital sign device; SafeMatch, a biometric iris identification system; RIVA, a compounding robot that prepares intravenous medications; and Xenex, a robot that disinfects hospital rooms using ultra-violet light.

References

1. Now Open, the Hospital of the Future. Palomar Medical Center. 2012 Aug 30.
2. Palomar Medical Center is first in nation to use wrist-worn patient vital signs device. Palomar Medical Center. 2013 Feb 25.

The cancer centers are uniting to transform cancer research through collaborative oncology trials that leverage the scientific and clinical expertise of the Big Ten universities listed below. The consortium forms a powerful collaboration because of the solid research infrastructure already existing at each university. The consortium also leverages geographical locations and existing relationships among the cancer centers.

According to Noah Hahn, M.D., executive officer of the consortium, associate professor of medicine at IU School of Medicine and a researcher at the IU Simon Cancer Center [1]:

 A critical byproduct of the Big Ten Cancer Research Consortium will be the creation of a new arena for junior faculty cancer researchers to design and lead potential practice-changing cancer studies. Opportunities for junior faculty to lead clinical trials have been evaporating in recent years, but the consortium aims to intentionally promote junior faculty participation and leadership in all trials under appropriate senior faculty guidance and mentorship in an effort to address those decreasing opportunities.

Patrick J. Loehrer Sr., M.D., director of the Indiana University Melvin and Bren Simon Cancer Center, added [1]:

Tremendous strengths exist in the cancer centers of the Big Ten. This is a rare opportunity for the universities to work together as part of a regional team science initiative to advance cancer research. The advantage of this, particularly during a time of austerity for research, is that we can build upon the strengths of the institutions and fortify some of the shortcomings. This allows us to be lean, efficient but, most importantly, collaborative.

The Big Ten Cancer Research Consortium consists of the following universities and cancer centers:

• Indiana University (Indiana University Melvin and Bren Simon Cancer Center)
• Northwestern University (Robert H. Lurie Comprehensive Cancer Center)
• Penn State University (Penn State Hershey Cancer Institute)
• Purdue University (Purdue University Center for Cancer Research)
• Rutgers University (The Cancer Institute of New Jersey becomes part of Rutgers on July 1)
• University of Illinois (University of Illinois Cancer Center)
• University of Iowa (Holden Comprehensive Cancer Center)
• University of Michigan (University of Michigan Comprehensive Cancer Center)
• University of Minnesota (Masonic Cancer Center)
• University of Nebraska (Fred & Pamela Buffett Cancer Center)
• University of Wisconsin (Carbone Comprehensive Cancer Center)

The Indianapolis-based Hoosier Oncology Group will serve as the administrative headquarters for the Big Ten Cancer Research Consortium. Since 1984, Hoosier Oncology Group has initiated more than 150 clinical trials with more than 4,000 patients.

References

1. IU Simon Cancer Center Joins Big Ten Cancer Research Consortium. Indiana University School of Medicine. 2013 May 31.

Alan Brown, M.D., M.P.H, of Columbia University and New York State Psychiatric Institute, a grantee of the NIH’s National Institute of Mental Health (NIMH), said:

Prospective mothers should take common sense preventive measures, such as getting flu shots prior to and in the early stages of pregnancy and avoiding contact with people who are symptomatic. In spite of public health recommendations, only a relatively small fraction of such women get immunized. The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn.

Brown and colleagues reported their findings online May 8, 2013 in the journal JAMA Psychiatry [1].

Although there have been hints of a maternal influenza/bipolar disorder connection, the new study is the first to prospectively follow families in the same HMO, using physician-based diagnoses and structured standardized psychiatric measures. Access to unique Kaiser-Permanente, county and Child Health and Development Study External Web Site Policy databases made it possible to include more cases with detailed maternal flu exposure information than in previous studies.

Among nearly a third of all children born in a northern California county during 1959-1966, researchers followed 92 who developed bipolar disorder, comparing rates of maternal flu diagnoses during pregnancy with 722 matched controls.

The nearly fourfold increased risk implicated influenza infection at any time during pregnancy, but there was evidence suggesting slightly higher risk if the flu occurred during the second or third trimesters. Moreover, the researchers linked flu exposure to a nearly sixfold increase in a subtype of bipolar disorder with psychotic features.

A previous study, by Brown and colleagues, in a related northern California sample, found a threefold increased risk for schizophrenia associated with maternal influenza during the first half of pregnancy. Autism has similarly been linked to first trimester maternal viral infections and to possibly related increases in inflammatory molecules.

Brown suggested:

Future research might investigate whether this same environmental risk factor might give rise to different disorders, depending on how the timing of the prenatal insult affects the developing fetal brain.

Bipolar disorder shares with schizophrenia a number of other suspected causes and illness features, the researchers note. For example, both share onset of symptoms in early adulthood, susceptibility genes, run in the same families, affect nearly one percent of the population, show psychotic behaviors and respond to antipsychotic medications.

Increasing evidence of such overlap between traditional diagnostic categories has led to the NIMH Research Domain Criteria (RDoC) project, which is laying the foundation for a new mental disorders classification system based on brain circuits and dimensional mechanisms that cut across traditional diagnostic categories.

The research was also funded by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Source: NIH News

References

1. Parboosing et al. Gestational Influenza and bipolar Disorder in Adult Offspring. JAMA Psychiatry. 2013 May 8:1-8. doi: 10.1001/jamapsychiatry.2013.896. [Epub ahead of print]
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The Scanadu Scout will be able to measure a person’s heart rate & ECG, blood pressure, temperature, respiratory rate and oximetry (blood oxygen level) within 10 seconds. The stats are displayed and stored on your smartphone.

To bring the Scanadu Scout to the consumer market as a medical-grade device, the company has to file with the FDA. Scanadu’s Indiegogo crowdfunding campaign for the Scout provides participants early access to an exploratory version of the device, and invites them to opt in to what will be a usability study. The exploratory version will be used as a research tool and collect data that will be submitted in a marketing application to regulatory authorities.

The 30-day campaign, which ends Friday, June 21, 2013, will offer a variety of perks from Scanadu. Supporters can reserve a first-edition of the Scanadu Scout for as little as $199 USD with an estimated delivery of March 2014.

Scanadu is a Singularity University startup based at NASA Research Park in Moffett Field, California. As such, the device is built on the Micrium platform, NASA’s real-time operation system for SAM (Sample Analysis at Mars) on the Rover Curiosity. The device uses a micro-USB adapter that you can hook up to a USB port and can be fully charged from low battery in less than an hour. When using it a few times a day, it will last for about a week.

The Scanadu app will come in Android and iOS versions. It will support Bluetooth 4.0 Smart Low Energy (LE). For more on the Scanadu Scout, check out the video below.

Source: Scanadu

Two new reports call that conclusion, straightforward as it may seem, into question. One examined how the other nutrients present in egg yolks can actually protect against coronary artery disease [2]. The other is a meta-analysis of data gathered from seventeen discrete studies designed to determine if egg consumption is linked to a higher incidence of stroke or coronary heart disease [3]. Both studies concluded that eating whole eggs (as opposed to egg whites) is not bad for your heart. In fact, it’s probably good for you.

In 2012, researchers from Maria Luz Fernandez’ laboratory in the Department of Nutritional Sciences at the University of Connecticut demonstrated that eating three whole eggs per day, so 534mg of cholesterol, for twelve weeks increased HDL levels in people who were overweight or already showing signs of metabolic syndrome when compared to HDL levels in similar people who ate only egg whites [4]. This three egg a day regimen was part of a high protein, low carbohydrate diet. HDLs, or high-density lipoproteins, are the particles that are responsible for cholesterol efflux: they clear cholesterol from your blood and bring it back to your liver. They are the ones known as “good cholesterol” since cholesterol efflux prevents atherosclerosis, the buildup of cholesterol and fat in the arteries.

Because HDL particles are composed of cholesterol and various fatty acids, these researchers hypothesized that perhaps the particular fatty acids present in egg yolks gave whole eggs their ability to increase HDL levels. While the ratios of the different fatty acids did not differ significantly in the HDLs of the group that ate the whole eggs and the one that ate only egg whites, the people who ate the whole eggs had a 2.4% increase in cholesterol efflux over the egg white eaters. This may seem modest, but each percentage increase in cholesterol efflux has been found to reduce the risk of coronary artery disease by 30%. The specific fatty acids present in egg yolks are also known to promote anticoagulant activity, and may help prevent blood clots that way.

Frank Hu, a Professor of Nutrition and Epidemiology at Harvard School of Public Health, oversaw a meta-analysis of seventeen studies undertaken over the last forty six and a half years that examined the effect of egg consumption on health [3]. Nine studies focused on coronary heart disease, and eight focused on stroke. He and his group determined that the consumption of up to one whole egg per day was not associated with an increased risk of either heart disease or stroke. Interestingly, they also found that among diabetics egg consumption was associated with a 50% increase in heart disease risk, but a 25% decrease in stroke risk. They warn that this result needs to be confirmed with more detailed studies.

They conclude that although diet is an important determinant of serum cholesterol, dietary cholesterol has only a modest impact on plasma concentrations of LDL cholesterol — low-density lipoprotein, the “bad cholesterol” that is a known risk factor for cardiovascular disease and stroke. Since eggs provide an inexpensive and low calorie source of many nutrients — proteins, minerals, vitamin D, and unsaturated fatty acids — they suggest that eating an overall well balanced diet, rather than simply cutting out eggs or egg yolks, is probably the best way to maintain heart and overall health.

References

1. Know Your Fats. American Heart Association. Accessed 2013 May 28.
2. Andersen et al. Egg Consumption Modulates HDL Lipid Composition and Increases the Cholesterol-Accepting Capacity of Serum in Metabolic Syndrome. Lipids. 2013 Mar 15.
   View abstract
3. Rong et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ. 2013 Jan 7;346:e8539. doi: 10.1136/bmj.e8539.
   View abstract
4. Blesso et al. Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome. Metabolism. 2013 Mar;62(3):400-10. doi: 10.1016/j.metabol.2012.08.014. Epub 2012 Sep 27.
   View abstract

The meta-analysis combined the results of eight studies published between 1990 and 2012 from the United States, northern Europe, Australia, and Japan. Scientists found that a simple seven gram increase in daily dietary fiber — equivalent to one serving of whole wheat pasta plus two servings of fruits or vegetables — was associated with a seven percent decrease in first-time stroke risk [1].

Dietary fiber is the part of the plant that the body is unable to completely digest. Fiber-rich foods include whole grains, vegetables, fruit, nuts and seeds.

Dr. Victoria Burley, the project lead from the School of Food Science and Nutrition at the University of Leeds said [2]:

Increasing your fibre intake doesn’t necessarily mean wholesale change to your diet. It might just mean switching from white bread to wholemeal, or from corn flakes to bran flakes. It’s a simple measure with a lot of benefits.

Want to increase fiber in your diet? For ideas, check out Mayo Clinic’s chart of high-fiber foods. For more high-fiber meal ideas, try the National Fiber Council’s Fiber Calculator.

How fiber works

Fiber moves quickly and reasonably easily through your digestive tract and helps it function properly. Fiber can lower blood sugar, cut cholesterol, and may even prevent colon cancer and help you avoid hemorrhoids. A high-fiber diet may also help reduce the risk of obesity, heart disease and diabetes.

In the stomach and small intestine, fiber promotes a sense of fullness, traps cholesterol and fats, and slows absorption of sugars. This helps to regulate your weight, lower cholesterol and improve blood glucose levels. In the large intestine (colon), fiber causes fermentation, promotes growth of healthy bacteria, and absorbs water, adding “bulk” to stool. This enhances your immune system to fight infection and chronic disease, and promotes regularity and elimination, minimizing constipation.

For more on how fiber works, check out the infographic below from the National Fiber Council.

References

1. Threapleton et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013 May;44(5):1360-8. doi: 10.1161/STROKEAHA.111.000151. Epub 2013 Mar 28.
   View abstract
2. Eating more fibre may lower risk of first-time stroke. University of Leeds. 2013 Mar 28.

Based in in Cambridge, Massachusetts, Sproxil provides a consumer SMS verification service through its Mobile Product Authentication (MPA) solution.

The technology empowers consumers in the war against product counterfeiting by using a cell phone to verify that they purchased a genuine product. Sproxil’s service is currently being used by several pharmaceutical companies in the fight against counterfeit drugs.

According to the World Customs Organization, the fake drug market is estimated to be a $200 Billion a year industry. The problem of counterfeit drugs is particularly acute in emerging markets, where an estimated 30% of drugs are fake and may be harmful or lethal to consumers.

Sproxil’s service places a scratch-off label on products. After purchasing a product, consumers scratch off the label to reveal a unique, random code. The code is sent via SMS to a country-specific short code, and the consumer receives a reply almost instantly indicating whether the product is genuine or not.

Check out a brief interview with Sproxil CEO Ashifi Gogo below.

Interested in other Fast Company Top 10 Most Innovative Companies in Healthcare 2013? Check them all out with the tag Fast Company 2013 Most Innovative Healthcare.

References

1. The World’s Top 10 Most Innovative Companies in Health Care. Fast Company. 2013 Feb 11.

The miniaturized device is just a few cubic millimeters in volume but includes five sensors and a radio transmitter.

Outside the body, a battery patch provides a 1/10 watt of power through the patient’s skin. A tiny electrical coil in the chip receives the power from the patch.

The implant emits radio waves over a safe frequency. The patch collects the data and transmits it via Bluetooth to the patient’s cell phone, which then sends it to a physician over the cellular network.

Implanted just beneath the skin, the chip can detect the concentration of up to five proteins and organic acids in the blood simultaneously. Each sensor is coated with an enzyme that reacts with a targeted substance, such as lactate, glucose, or adenosine triphosphate (ATP).

The enzymes currently being tested are good for about a month and a half, which is already long enough for many applications.

The device was developed by a team led by EPFL scientists Giovanni de Micheli and Sandro Carrara. According to de Micheli:

Potentially, we could detect just about anything. But the enzymes have a limited lifespan, and we have to design them to last as long as possible. In addition, it’s very easy to remove and replace the implant, since it’s so small.

The implant could be used in many applications, from chemotherapy to continuously monitor a patient’s drug tolerance, to chronic illness where the chip could monitor for problems — and send alerts — before symptoms emerge. The researchers hope the system will be commercially available within four years.

Source: Swiss Federal Institute of Technology in Lausanne

On Friday, the American Urological Association (AUA) announced that men under the age of 55 should not get routinely screened with a PSA test  [1]. Men who are between the ages of 55 and 69 should talk with their doctors about the benefits and harms of testing and proceed based on their personal values and preferences.

The new guidelines for early detection of prostate cancer were developed using evidence from a systematic literature review rather than consensus opinion, and provides rating and interpretation of the evidence based on randomized controlled trials with modeled and population data as supporting evidence. The AUA panel acknowledged that ongoing research, including studies on biomarkers other than PSA, may lead to changes in the guidelines statements, and announced plans to regularly update the guidelines based on new evidence.

Unlike other types of cancers, prostate cancer is typically a slow-growing cancer. And although cancer develops in the prostate in most men as they age, it causes no trouble for most of them. Autopsy studies of men who died from something other than prostate cancer show that 30% of men over age 50 and 70% of men over age 70 have some cancerous cells in their prostate [2]. The cancers were too small to be detected by biopsy. The development of the PSA test changed this. While the PSA test can detect the presence of cancerous prostate cells, it can’t distinguish between ones that pose no threat to health from those that will.

In May 2012, the U.S. Preventive Services Task Force (USPSTF) — an independent panel of medical experts that advise the government on treatment guidelines — released a recommendation that healthy men should not get routinely screened with a PSA test for prostate cancer, citing a number of harms related to screening and diagnostic procedures [3].

The recent AUA announcement is in sharp contrast from last year, when the organization blasted the Task Force for its recommendation, saying that they were “outraged at the USPSTF’s failure to amend its recommendations on prostate cancer testing to more adequately reflect the benefits of the prostate-specific antigen (PSA) test in the diagnosis of prostate cancer” [4].

The PSA test is used to measure levels of prostate-specific antigen (PSA), a protein produced by the prostate, in the blood. PSA is a biomarker for prostate cancer.

Dr. H. Ballentine Carter, who chaired the panel that developed the guideline, said in a press release [1]:

There is general agreement that early detection, including prostate-specific antigen screening, has played a part in decreasing mortality from prostate cancer. The randomized controlled trials are more mature at this point and there is more data available today than there was in 2009. It’s time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms.

To further reduce the harms of cancer screening, for those men who have decided on screening, the AUA guidelines suggest a routine screening interval of two years or more instead of an annual screening to preserve the majority of screening benefits and reduce over diagnosis and false positives.

The guidelines do not recommend routine PSA screening in men over age 70 or any man with less than a 10-15 year life expectancy.

References

1. AUA Releases New Clinical Guideline on Prostate Cancer Screening. American Urological Association press release. 2013 May 3.
2. PSA Screening for Prostate Cancer. Weill Cornell Medical College. Accessed 2012 May 5.
3. Screening for Prostate Cancer. U.S. Preventive Services Task Force Recommendation Statement. 2012 May.
4. AUA Disputes Panel’s Recommendations on Prostate Cancer Screening. American Urological Association press release. 2012 May 21.

The cause of tooth decay and cavities

Research in the late 1940s and early 1950s established that fluoride helps to harden tooth enamel, which protects teeth from the acid produced by decay-causing bacteria [2-4]. Subsequent studies showed that fluoride enhances the tooth remineralization process [5-6].

Tooth decay and cavities are caused by tooth demineralization, a process where an acidic environment draws out some of the mineral content from a tooth’s calcium-hardened tissues. The acids that cause demineralization are produced by specific types of bacteria — primarily Streptococcus mutans and Lactobacillus — that live within dental plaque, the pale yellow biofilm that develops naturally on the teeth.

Fluoride enhances tooth remineralization (think of remineralization as tooth decay in reverse). Fluoride absorbs onto tooth surfaces where demineralization, or tooth decay, has occurred. The presence of fluoride attracts other minerals, increasing the rate of remineralization. In fact, the new tooth mineral created from remineralization is actually harder than the tooth was to begin with.

Another mechanism for fluoride against tooth decay

Researchers from the Saarland University in Germany report that fluoride also works by reducing the ability of decay-causing bacteria to stick to teeth, making it is easier to wash away the bacteria by saliva, brushing and drinking.

To characterize bacterial adhesion on fluoridated samples, experiments were performed on artificial teeth to allow for high-precision analysis techniques. Using force spectroscopy — an analytical technique that allows for the study of the mechanical properties of single polymer molecules, proteins or individual chemical bonds — scientists employed bacterial probes to directly measure adhesion forces. They tested the adhesion of different species of bacteria, including two cariogenic (meaning to cause tooth decay) microorganisms: Streptococcus mutans and Streptococcus oralis.

All bacteria tested, regardless of species, showed decreased adhesion after fluoride treatment of the teeth. The findings suggest that the decrease of adhesion properties is a further key factor for the cariostatic (meaning to stop tooth decay) effect of fluoride in addition to the decrease of demineralization. Understanding fluoride’s effect on bacterial adhesion has the potential to help develop better dental fillings, dental and medical implants.

Community water fluoridation

In the United States, the fluoridation of community water started in 1945, and is the single most effective public health measure to prevent tooth decay.

In a recent letter presented during the 2013 National Oral Health Conference, U.S. Surgeon General Regina Benjamin, M.D., praised community water fluoridation for its effectiveness in preventing tooth decay [7]:

Fluoridation’s effectiveness in preventing tooth decay is not limited to children, but extends throughout life, resulting in fewer and less severe cavities. In fact, each generation born since the implementation of water fluoridation has enjoyed better dental health than the generation that preceded it.

The Centers for Disease Control and Prevention has proclaimed community water fluoridation as one of 10 great public health achievements of the 20th century.

References

1. Loskill et al. Reduced Adhesion of Oral Bacteria on Hydroxyapatite by Fluoride Treatment. Langmuir. 2013 Apr 23. [Epub ahead of print]
   View abstract
2. Van Huysen and Muhler. Enamel solubility reducing effect of flavored low concentration stannous fluoride solution. J Dent Res. 1948 Feb;27(1):46-51.
   View abstract
3. Phillips and Swartz. Effect of fluorides on hardness of tooth enamel. J Am Dent Assoc. 1948 Jul;37(1):1-13.
   View abstract
4. Ericsson Y. Reduction of the solubility of enamel surfaces. Acta Odontol Scand. 1950 Mar;9(1):60-83.
   View abstract
5. Feagin et al. Study of the effect of calcium, phosphate, fluoride and hydrogen ion concentrations on the remineralization of partially demineralized human and bovine enamel surfaces. Arch Oral Biol. 1971 May;16(5):535-48.
   View abstract
6. Gron et al. The effect of topically applied fluoride on enamel remineralization in vitro. Arch Oral Biol. 1975 Mar;20(3):223-4.
   View abstract
7. ADA Welcomes Surgeon General Endorsement of Community Water Fluoridation. American Dental Association. 2013 Apr 22.

The collaboration between the two companies aims to expand iRx Reminder’s bidirectional smartphone-based solutions focused on improving real-time data collection and lowering costs of clinical trials.

iRx Reminder is an Akron, Ohio-based mobile health application service provider focused on medicine, device, and behavior research. The iRx Reminder smartphone app provides for the direct capture of in-the-moment, electronic data from patients and clinical study participants. Digital data is sent from the patient’s smartphone to a web accessible control center in real time.

Based in New York, New Directions Technology Consulting is a healthcare consultancy that develops commercial opportunities for its corporate, trade and professional associations. New Directions Technology Consulting is the exclusive market developer of the mMed mobile medication management patent portfolio, which goes beyond “take your medicine” reminders, “refill your prescription” alerts, and self-tracking solutions. The mMed mobile medication management patent portfolio could provide the foundation for tools to help patients outside the doctor’s office or hospital to take actions required to make and keep themselves well.

mMed’s patents apply to securing usage information for medication and other healthcare products in the hands of patients, away from physical locations of medical professionals, and cover the possible development of an auto-injector with embedded sensors, enabling a medication carrying case with reporting ability and incorporating a central monitoring facility with medical professionals to intervene and enable medical management.

Couple mMed technology with iRx Reminder’s bidirectional smartphone communications, which enables tracking, reporting, feedback and interactions for data gathering or education, and you have the key to clinical protocol compliance and clinical trial success. In a press release [1], iRx Reminder founder and CEO Anthony Sterns, Ph.D., said:

Combining our patented technologies with the mMed portfolio will let us enhance our SaaS mobile health offering, which already has been shown to reduce dropout rates, improve data accuracy and speed up completion times of clinical trials. As a licensee of the mMed patents, iRx Reminder can expand its options for monitoring protocol compliance and improving medication adherence with a variety of drug-delivery systems, including tablets, capsules, injectables and inhalers.

Mobile application developers are starting to enable the mHealth industry to successfully monetize their services. The market for mHealth services has now entered the commercialization phase and is expected to reach $26 billion globally by 2017 [2].

References

1. New Directions Technology Consulting Inks Deal with iRx Reminder to Co-develop Bidirectional, mHealth, Smartphone Solutions for Clinical Trials. New Directions Technology Consulting. 2013 Apr 23.
2. Global Mobile Health Market Report 2013-2017. research2guidance. 2013 March.

Schizophrenia is a complex metal disorder that affects more than 1 percent of the world’s population and causes severe mental disturbances that disrupt normal thoughts, speech, and behavior. Schizophrenia makes it hard to think clearly, have normal emotional responses, act normally in social situations, and tell the difference between what is real and what isn’t.

In the study, researchers integrated results from a meta-analysis (i.e. a study of other studies) of 18 genome-wide association studies (GWAS) involving nearly 22,000 patients and over 1 million genetic markers called ‘SNPs’ (pronounced “snips”) that appeared to point to schizophrenia risk. SNPs are DNA sequence variations that occur when a single nucleotide — Adenine, Thymine, Cytosine and Guanine — in the genome is changed. These small variations in DNA sequence make up almost 90% of all human genetic variation.

Scientists then systematically collected results from other kinds of biological schizophrenia studies that studied 6,298 individuals from 1,811 nuclear families and combined all the results using a novel data integration approach.

The 9,380 most promising SNPs were then genotyped against a large, independent collection of families with schizophrenia patients, an experimental design that avoids issues that have troubled previous genetic studies of schizophrenia.

SNPs in the genes Transcription Factor 4 (TCF4) and Notch Homolog 4 (Drosophila) (NOTCH4) were among the most robust findings. More novel findings included POM121L2, Arsenic (+3 oxidation state) Methyltransferase (AS3MT), Cyclin M2 (CNNM2), and 5-Prime, Cytosolic II Nucleotidase (NT5C2).

Biological pathway analysis showed that the most significant pathways associated with genes that contribute to risk for schizophrenia were involved in neuronal function and the immune system. VCU researchers are already pursuing tests to study TCF4, which controls the expression of other brain genes.

According to principal investigator Edwin van den Oord, Ph.D., professor and director of the Center for Biomarker Research and Personalized Medicine in the Department of Pharmacotherapy and Outcomes Science at the VCU School of Pharmacy [2]:

Now that we have genes that are robustly associated with schizophrenia, we can begin to design much more specific experiments to understand how disruption of these genes may affect brain development and function. Also, some of these genes provide excellent targets for the development of new drugs.

The research included efforts from scientists in Denmark, Sweden, the United Kingdom, Norway and the United States. A similar international study in 2012 also mapped the genomic and biological landscape for schizophrenia, and, among others, identified the TCF4 gene and implicated neuronal pathways [3].

References

1. Aberg et al. A Comprehensive Family-Based Replication Study of Schizophrenia Genes. JAMA Psychiatry. 2013 Feb 1;70(2):1-9. doi: 10.1001/jamapsychiatry.2013.288.
   View abstract
2. Researchers Confirm Multiple Genes Robustly Contribute to Schizophrenia Risk in Replication Study. Virginia Commonwealth Univeristy. 2013 Apr 9.
3. Ayalew et al. Convergent functional genomics of schizophrenia: from comprehensive understanding to genetic risk prediction. Mol Psychiatry. 2012 Sep;17(9):887-905. doi: 10.1038/mp.2012.37. Epub 2012 May 15.
   View abstract

The human skin and digestive tract are literally crawling with bacteria, some pathogenic (disease-causing) and some harmless. In recent decades, researchers have begun to study the role of beneficial bacteria — such as the Lactobacillus acidophilus that’s found in a healthy human gut – that aren’t just harmless, but are actually protective. In the digestive tract, pathogenic bacteria have to compete for resources, including nutrition, like any other species on Earth. If there are lots of non-pathogenic bacteria like P. acidophilus present, they make it harder for the pathogenic strains to colonize the gut and cause infection.

New research suggests that a similar dynamic may be playing out on the surface of the skin, and that protective bacterial strains on an individual’s skin may reduce the likelihood of acne. Though scientists have known for quite some time that the development of acne is an infectious process — it’s mediated by bacteria, which is why cleanliness is so important and why severe cases can be treated with antibiotics — the specific strains involved and the mechanism by which they cause infection aren’t well understood. A research team led by Dr. Huiying Li at the University of California, Los Angeles, examined the skin of both acne sufferers and those with clear complexions in an attempt to catalogue microbial populations. What they found intrigued them.

The species Propionibacterium acnes has long been associated with development of facial blemishes, but Li’s team found scores of strains of P. acnes, many of which were previously unknown. Even more interesting, two particular strains were found almost exclusively on the faces of individuals with blemished skin, while a third strain was largely limited to those with clear skin. The team hypothesizes that the strain associated with clear skin — called P. acnes RT6 — may actually be fighting acne-causing strains such as the two found on the skin of those with blemishes.

While this hypothesis is an interesting one and certainly warrants further research, it’s important to remember that the data gathered through this research are correlational rather than causal. In other words, it’s not yet scientifically reasonable to conclude that the RT6 strain fights acne-causing bacteria, and therefore supplemental RT6 would benefit those with acne. Further experimentation may eventually allow this conclusion, however. Should more research show that RT6 is indeed protective, it’s possible that it might be beneficial when used as a probiotic supplement, similar to L. acidophilus. Even more to the point, it could be that antibiotics will eventually be abandoned as a treatment for acne, on the grounds that killing all bacteria, including the “helpful” ones (such as P. acnes RT6, should it prove to be beneficial), is not the best way to treat acne.

References

1. Fitz-Gibbon et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2013 Jan 21. doi: 10.1038/jid.2013.21.
   View abstract

Fast Company’s annual guide to the state of innovation in our economy includes 10 businesses for 2013 whose innovations are having the greatest impacts across healthcare and our culture as a whole. To assemble the annual list, Fast Company evaluates thousands of businesses based on creativity, real-world impact, risk taking, and execution.

First up: Proteus Digital Health.

Founded in 2001 and headquartered in Redwood City, California, Proteus Digital Health focuses on developing and commercializing digital health products that collect and aggregate various behavioral, physiologic, and therapeutic metrics into personal management tools that are delivered to consumer mobile devices.

The company’s products include Helius, a healthshare solution that keeps families in tune with those who need care, and Avery Metria for BodyMedia, a compact, lightweight and disposable 7-day body monitor patch created to address consumers who want to lose weight and live healthier lives.

Proteus Digital Health’s Caregiver Solutions and Lifestyle Tools rely on the company’s digital health feedback system that integrates sensor technology, powered by you. It includes wearable and ingestible sensors that work together to detect ingestions and physiologic data. By capturing objective information and providing actionable insights, you can take control, communicate with caregivers and clinicians, and stay well. Check out the Proteus Digital Health video below.

Interested in other Fast Company Top 10 Most Innovative Companies in Healthcare 2013? Check them all out with the tag Fast Company 2013 Most Innovative Healthcare.

References

1. The World’s Top 10 Most Innovative Companies in Health Care. Fast Company. 2013 Feb 11.

Most DNA molecules are double-stranded helices, consisting of two long polymers of nucleotides. Each nucleotide contains one of four nucleobases: adenosine (A), thymine (T), cytosine (C), or guanine (G). DNA is a reliable storage medium because of its double-stranded structure, which provides a built-in duplicate of the encoded information. It is durable because its backbone is resistant to cleavage.

Dr. Goldman and his team used DNA to archive data from five different types of computer files, including a photograph, sonnets by William Shakespeare, and a 26-second audio excerpt from Martin Luther King, Jr.’s “I have a dream” speech. To do so, they used an encoding scheme that converted the files’ binary code (0s and 1s) first into a trinary code (0s, 1s and 2s) and then into the four DNA bases. Unlike previous attempts, their method avoided sequences of identical nucleobases in the DNA code, which are prone to errors.

The DNA code generated from the computer files was then sent to California-based Agilent Technologies who used it to synthesize a mass of DNA fragments no bigger than a speck of dust. To show that the computer files could in fact be retrieved from the DNA, Goldman and his team used standard procedures and equipment to sequence the DNA. The files were reconstructed almost perfectly; only two 25-base segments of DNA were missing.

There are definitely limitations with using DNA to store data in terms of it being readily accessible. It took the researchers two weeks to reconstruct the five files. However, the advantages, particularly for infrequently accessed digital archiving, are compelling. For one, the durability of DNA is unparalleled, as can be evidenced by the DNA extracted from Woolly mammoths living tens of thousands of years ago or the DNA extracted from Greenland plants and insects living 800,000 years ago. Secondly, its storage density is nothing short of extraordinary, giving a whole new meaning to the word “compact”. Finally, the method lends itself to built-in error correction to ensure accuracy.

According to Dr. Goldman:

We’ve created a code that’s error tolerant using a molecular form we know will last in the right conditions for 10 000 years, or possibly longer. As long as someone knows what the code is, you will be able to read it back if you have a machine that can read DNA.

Given the ever-decreasing price of synthesizing and sequencing DNA and the work underway to make the retrieval process speedier, the commercial feasibility of this biological storage medium seems certain.

References

1. Goldman et al. Towards practical, high-capacity, low-maintenance information storage in synthesized DNA. Nature. 2013 Feb 7;494(7435):77-80. doi: 10.1038/nature11875. Epub 2013 Jan 23.
   View abstract
2. Data storage in DNA becomes a reality. EMBL-European Bioinformatics Institute. 2013 Jan 23.

Ayasdi’s Iris platform uses topological data analysis to highlight underlying geometric shapes in data and creates stunning three dimensional visualizations of entire massive data sets, rather than smaller queries and data slices. The system discovers correlations between data points and creates a map of the dataset and the connections between every point within it.

The real utility in the Iris platform is that users can see the correlations without having to think up and ask the questions that would expose those connections.

Think of your favorite social network

If you’re familiar with social networking, you’ll likely understand how the Iris platform works. Our social network, or social graph as Facebook calls it, is a map of the connections between ourselves and our friends. Clusters of people, termed “nodes”, and their connections, termed “edges”, show who’s connected to whom. People more closely connected have shorter edges or less distance between them. Introduce another variable, such as geographic location or interest, and the network will often reflect spatially distinct clusters within the map (see the Ayasdi example below).

In a research study published in 2011 using over a decade’s worth of data mined from the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Ayasdi identified a new, previously undiscovered population of breast cancer survivors, classified as c-MYB+ breast cancer [1]. The unique subgroup of estrogen receptor-positive (ER+) breast cancers expressed high levels of c-MYB and low levels of innate inflammatory genes. The patients exhibited 100% survival with no metastasis.

The Iris platform offers new methods of unlocking potential of streamlined and personalized medicine, and the technology may one day allow oncologists to map their patient’s data onto existing data and develop personalized cancer therapy strategies.

In the video below, co-founder and president of Ayasdi, Dr. Gunnar Carlsson, introduces topological data analysis.

References

Nicolau et al. Topology based data analysis identifies a subgroup of breast cancers with a unique mutational profile and excellent survival. Proc Natl Acad Sci U S A. 2011 Apr 26;108(17):7265-70. doi: 10.1073/pnas.1102826108. Epub 2011 Apr 11.
View abstract 

In a healthy eye, the photoreceptors (rods and cones) in the retina of the eye convert light to electrical signals that then travel via the optic nerve to the visual cortex in the brain. Argus II is indicated for patients with a condition called retinitis pigmentosa, a genetic disorder that damages the photoreceptors. The rest of the neural pathway still functions normally, but without the photoreceptors, vision is lost.

The Argus II system bypasses the damaged photoreceptors and transmits visual information directly to the remaining healthy retinal cells.

The system consists of both external and internal components. The patient wears eyeglasses integrated with a miniature video camera and transmitter, as well as a small video processing unit (VPU) on a belt or strap. Internally, a prosthesis consisting of an electronics case, receiver, and array of 60 electrodes is implanted on the retina during a surgical procedure that generally takes about 4 hours.

The video camera captures an image from the patient’s environment and sends it to the VPU, which processes the information into a series of electrical pulses representing patterns of light and dark. The electrical pulses are sent back to the transmitter in the eyeglasses and from there are wirelessly transmitted to the retinal implant. The implant’s 60-channel microelectrode array stimulates the remaining retinal cells and the electrical pulses are transmitted via the optic nerve to the brain. This system allows patients to perceive patterns of light that they can learn to recognize as movement, colors, and objects. Check out a video of the system below.

The restored vision is definitely limited; data from 60 electrodes cannot compare to the millions of impulses processed in a healthy eye. But for someone who is blind, what it does provide — the ability to detect objects in one’s path, distinguish black from white, or see cars moving in a street — is nothing short of life changing.

In order to obtain FDA approval, the safety and utility of Argus II was studied in 30 patients with severe to profound retinitis pigmentosa. Visual acuity was measured with and without the system, and indeed, most patients performed significantly better at orientation and mobility tasks when using the system. The long-term safety of the implant was acceptable, with about 70% of patients having no serious adverse events (defined as leading to a permanent impairment or requiring a medical intervention).

Second Sight has also tested whether the Argus II system can be used in a “direct stimulation mode” to read visual Braille, which theoretically would be faster than reading tactile Braille. Direct stimulation mode bypasses the video camera and instead uses a computer to directly stimulate the retinal implant. The proof of concept study, reported in Frontiers in Neuroscience in November 2012, was conducted in a single patient [2]. The subject was able to correctly identify 89% of individual letters and 60-80% of short words, results that are expected to improve with training.

Argus II, which has been marketed in Europe since 2011, is the first FDA-approved retinal prosthesis and slated to be available in U.S. clinical centers later this year. According to Second Sight, Argus II is expensive, with the total cost expected to be at least $100,000. The company has also said it is studying the device for the treatment of macular degeneration, an indication it is “likely” to pursue.

References

1. Second Sight Medical Products Receives FDA Approval for Argus II System. Second Sight. 2013 Feb 14.
2. Lauritzen et al. Reading visual braille with a retinal prosthesis. Frontiers in Neuroscience. Front Neurosci. 2012;6:168. doi: 10.3389/fnins.2012.00168
   View abstract

In 2010, the Pew Research Center reported that “the online health-information environment is going mobile” [1]. In 2010, 17% of cell phone users reported using their phones to look up health or medical information and 9% had apps on their phones that helped them track or manage their health. Flash forward to 2012 and those numbers have doubled. In 2012, 31% of cell phone owners reported using their phones to look for health information and 19% had at least one health app [2].

Translate those percentages into hard numbers and we’re talking about 33 million people that use their phone to search for health information and 20 million that have at least one health app. Mobile health — frequently called “mHealth” — has indeed found its market: smartphone owners.

Infographic: Healthcare On the Go

Franklin Street, a branding and advertising agency specializing in health and wellness, recently posted the infographic below on mobile health. It’s somewhat ironic that cell phones are the platform for mobile health given the health hazards of mobile devices. Nevertheless, mobile is still a big deal for healthcare. By the year 2015, it’s projected that 500 million people will have health-related apps on their smartphones [3].

Many healthcare-focused organizations are coming to the realization that more and more people are accessing their websites via mobile devices. Although they’ve been reluctant to embrace online advertising, as smartphones become more integrated in healthcare, advertising is following. Firms such as Franklin Street are encouraging these companies to invest in online health advertising and “get ahead of the curve.”

Digital marketing agency Heartbeat Ideas encourages its healthcare clients to put as much of their ad budget as possible into searches including mobile advertising [4]. According to Lee Slovitt, Heartbeat’s media director, “The return on investment [for mobile advertising] is much higher than radio or TV. If searchers are actively looking for information on a given condition or a specific drug, they are much more likely to respond to a commercial message.”

Via: Junto

References

1. Mobile Health 2012. Pew Internet & American Life Project. 2012 Nov 8.
2. Mobile Health 2010. Pew Internet & American Life Project. 2012 Oct 19.
3. Global Mobile Health Market Report 2010-2015. research2guidance. 2010 Nov 10.
4. As Smartphones Become Health Aids, Ads May Follow. New York Times. 2012 Apr 1.